Provider Demographics
NPI:1750893624
Name:SOONG, TAWNYA LYNN BROWN (LCSW, CADC1)
Entity type:Individual
Prefix:
First Name:TAWNYA
Middle Name:LYNN BROWN
Last Name:SOONG
Suffix:
Gender:F
Credentials:LCSW, CADC1
Other - Prefix:
Other - First Name:TAWNYA
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3941 CROWN AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-1833
Mailing Address - Country:US
Mailing Address - Phone:541-221-4386
Mailing Address - Fax:360-729-3025
Practice Address - Street 1:1200 HILYARD ST STE 540
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-8122
Practice Address - Country:US
Practice Address - Phone:458-205-7070
Practice Address - Fax:458-205-7089
Is Sole Proprietor?:No
Enumeration Date:2017-10-31
Last Update Date:2024-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 101Y00000X
ORL118401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical